Individual
DIVINE ACHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
HOME HEALTH AIDE
Contact information
Practice address
2811 PENNSYLVANIA AVE SE, WASHINGTON, DC 20020-3865
(202) 894-6811
Mailing address
6419 JODIE ST, NEW CARROLLTON, MD 20784-3633
(301) 537-0970
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
06/07/2012
Last updated
12/07/2023
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